Levalbuterol vs. albuterol for hospitalized patients with COPD in China: cost-utility and budget impact analysis

Abstract

Objectives

For hospitalized patients with chronic obstructive pulmonary disease (COPD), albuterol and levalbuterol can both be used as relievers to alleviate bronchoconstriction. This study aimed to evaluate levalbuterol and albuterol's cost-utility and budget impact in hospitalized patients with COPD.

Interventions

A cost-utility analysis was used to evaluate the impact on the costs of nebulized levalbuterol verse albuterol in hospitalized patients with COPD. The decision tree model was employed to estimate the incremental cost per quality-adjusted life year in the admission setting. A budget impact model was used to examine the impact of budget on levalbuterol's entry into the Chinese market from the healthcare system's perspective. One-way sensitivity and probabilistic sensitivity analyses were performed to test the uncertainty of the parameters.

Results

The cost-utility results showed that levalbuterol saved ¥495.7 ($105.1) per hospitalization, while the budget impact analysis revealed a potential saving of ¥22.3 ($6.8) million in 3 years. The sensitivity analysis indicated that the results were robust to the changes in input parameter values.

Conclusion

Levalbuterol is a cost-saving option for treating hospitalized patients with COPD in China.

PLAIN LANGUAGE SUMMARY

Chronic obstructive pulmonary disease (COPD) is a common disease in China, with an increased financial burden over the years. Nebulized albuterol is the most commonly used short-acting beta2-agonist, often regarded as the initial bronchodilator to treat hospitalized COPD patients. Its R-isomer, levalbuterol, entered the Chinese market in 2019. The new intervention always impacts the expenditure of the health system. We built a cost-utility and budget impact model to analyze the difference between albuterol and levalbuterol. The cost-utility results showed that levalbuterol saved ¥495.7 ($105.1) per hospitalization compared with albuterol, while the budget impact analysis revealed a potential saving of ¥22.3 ($6.8) million in 3 years.

Keywords:

• Albuterol
• budget impact analysis
• chronic obstructive pulmonary disease
• cost-utility analysis
• levalbuterol

JEL CLASSIFICATION CODES:

• A13
• A1
• A
• A10

Transparency

Declaration of funding

This research received no specific grant from any funding agency in public, commercial, or not-for-profit sectors.

Declaration of financial/other relationships

The authors report that there are no competing interests to declare.

Author contributions

LC and XC participated in the study's design, adapted the model, performed the economic analysis, and drafted the manuscript. CZ and XL participated in interpreting the results and model adaptation and critically revised the article. YH helped and oversaw the study, reviewed the manuscript, and acted as a guarantor for the overall content. All authors proofread and approved the final manuscript and agree to be accountable for all aspects of the work.

Acknowledgements

The authors thank Dandan Zhao (Joincare, Shenzhen, China) for editorial support during the development of this manuscript.

Data availability statement

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.